Supporting community-based exercise in long-term neurological conditions: experience from the Long-term Individual Fitness Enablement (LIFE) project

BACKGROUND: Patients with long-term neurological conditions often have low levels of physical activity and participation in exercise. Exercise referral schemes have been introduced in the UK to encourage physical activity in sedentary and clinical populations but typically exclude patients with long-term neurological conditions. We have developed and evaluated an exercise support system for people with long-term neurological disability, called the Physical Activity Support System, to enable them to use local gym facilities safely and effectively. The intervention: We describe the Physical Activity Support System for people with long-term neurological conditions and provide data on the use of this system in a phase II randomized controlled study trial. The system has five key components: access and transport advice, the fitness instructor, the gym, health professional support and how to exercise safely. RESULTS: Ninety-nine patients with a range of long-term neurological conditions used six different community exercise facilities in Oxfordshire and Birmingham. Average gym attendance was one session per week for 12 weeks. Participants required an average of three 1-hour face-to-face physiotherapy contacts to achieve this. The average direct cost for the support system was £275. CONCLUSIONS: The scheme achieved comparable exercise participation to standard GP exercise referral schemes operating in the same centres and offers a relatively cheap, practical and feasible system for supporting people with long-term neurological conditions

A Q-methodology study of patients' subjective experiences of TIA

Background. An expanding body of research has focused on a range of consequences of TIA. However, no work has been conducted on the patient’s subjective experience of TIA. Aim. To capture patients’ first-hand experiences of TIA. Method. Using Q-methodology which employs both qualitative and quantitative approaches, 39 statements relating to the clinical, physical, affective, and psychological impact of TIA were distilled from the literature and from patient narratives. Consistent with conventional Q-methodology, a purposive sample of twentythree post-TIA patients sorted these statements into a normally-distributed 39-cell grid, according to the extent to which each represented their experience of TIA. Results. Casewise factoranalysis was conducted on the sorted statements. Eight factors emerged which were labelled: lack of knowledge/awareness of TIA; life impact; anxiety; interpersonal impact; depression; physical consequences; cognitive avoidance/denial; constructive optimism. Conclusions. Five of the eight factors confirmed existing research on the impact of TIA, but three new issues emerged: deep-seated anxiety, denial and constructive optimism. The emerging perspectives highlight areas to target in the management of TIA and could inform health education messages, patient information, individualised caremanagement, and enhancement of coping strategies. With development, the findings could be used as a basis for psychometric risk assessment of TIA patients

Foundation in the Field: The Ford Foundation New Delhi Office and the Construction of Development Knowledge, 1951-1970

In recent years, historians have uncovered a good deal about the domestic production and circulation of development knowledge between US philanthropies and US universities. They have begun to trace as well the role of US foundations in the formation of transnational epistemic communities of experts that cohered around, and defined, developments such as population control, food production and economic planning initiatives.3 The voice of the foundation in these histories nevertheless remains largely that of the foundation presidents and senior officers in New York. This article, however, intends to shift our perspectives on the foundations and the construction of development from the “centre” in New York to the “periphery” by examining the history of the Ford Foundation’s New Delhi office and its representative Douglas Ensminger, who directed the office from 1952-1970. As such, it provides the first historical examination of a foundation field office and the critical role such offices played in the making of development knowledge, policy and practice during the Cold War

Peace Corps at 50: Bringing the World Back Home

Both the critics and defenders of the Peace Corps judge the organization on its ability to change other nations\u27 views of the United States, either by offering technical assistance or by making friends for the United States in the world. What is missing from these debates is a frank acknowledgment that the Peace Corps teaches Americans as much as it serves the world. The organization\u27s greatest value may be in bringing the world back home through its more than 200,000 former volunteers

The Village as Cold War Site: Experts, Development, and the History of Rural Reconstruction

This article examines ‘the village’ as a category of development knowledge used by policymakers and experts to remake the ‘Third World’ during the Cold War. The idea of the village as a universal category of underdevelopment, capable of being remade by expert-led social reform, structured efforts to win the ‘hearts and minds’ of people from Asia to Latin America and Africa. Rooted in a transnational interwar movement for rural reconstruction, village projects were transformed in the 1950s and 1960s by a scientization of development that narrowed the range of experts in the field and by Cold War politics that increasingly tied development to anti-communism and counterinsurgency. From India to Central America, strategic efforts to control rural populations won out over concerns for rural welfare

The Power Elite

Over the past decade, scholars have begun to write the international history of the foundations. Influenced by the transnational turn in U.S. history as well as growing interdisciplinary interest in the role of non-state actors on the world stage, scholars such as Sunil Amrith, Volker Berghahn, Mary Brown Bullock, Anne-Emmanuelle Birn, Matthew Connelly, David Ekbladh, David Engerman, and John Krige have treated U.S. foundations as important international players. Some of these scholars have focused on foundations’ efforts in particular regions or nations. Others have shown how Carnegie, Rockefeller, and Ford helped to construct new global problems (underdevelopment, hunger, population control) as well as the transnational networks through which particular approaches to those problems emerged and came to dominate international practice. All of the new work has been grounded in close analysis of foundation records. What we have lacked is a full accounting of the evolution of the U.S. foundations’ ideologies and international grant-making in the context of a changing world order and of particular conditions in the field. We also need a study that looks closely at the relationship between foundations and the state over the course of the twentieth century

Cosmopolitanism and the Uses of Tradition: Robert Redfield and Alternative Visions of Modernization during the Cold War

The history of the rise and fall of “modernization theory” after World War II has been told as a story of Talcott Parsons, Walt Rostow, and other US social scientists who built a general theory in US universities and sought to influence US foreign policy. However, in the 1950s anthropologist Robert Redfield and his Comparative Civilizations project at the University of Chicago produced an alternative vision of modernization—one that emphasized intellectual conversation across borders, the interrelation of theory and fieldwork, and dialectical relations of tradition and modernity. In tracing the Redfield project and its legacies, this essay aims to broaden intellectual historians’ sense of the complexity, variation, and transnational currents within postwar American discourse about modernity and tradition

\u3cem\u3eWriting Regionalism into the History of Modernization: A Review of Nathan Citino’s\u3c/em\u3e Envisioning the Arab Future (Book Review)

In 1900, Methodist minister and Chautauqua movement leader Jess Lyman Hurlbut published a guide to the Holy Land featuring “one hundred stereographed places in Palestine.” A proselytizer for ‘Biblical history,’ Hurlbut imagined the popular nineteenth-century technology of the handheld stereoscope to possess “magical…power to give us a vivid realization of the actuality of the Biblical narrative.” Its illusion of three-dimensional depth through two juxtaposed photographs would enable Americans at home to “stand…in the very presence of Palestine” and “think [themselves] into those far-away lands.” Through stereoscopes and accompanying guides, Hulbert and other turn-of-the-twentieth-century Western travelers attempted to construct a Near East fully knowable to Western imperial eyes. Hulbert’s guide superimposed Orientalist tropes and apocryphal Biblical meaning onto street scenes in contemporary Jerusalem, Damascus, and Hebron.[21] Yet the stereoscope, as art historian Jonathan Crary notes, differed from still photography in that “the disjunction between experience and its cause…the composite, synthetic nature of the stereoscopic image could never be fully effaced.”[22] By the 1920s, the stereoscope had lost out to photography and film as a techne of seeing, in part because of its inability to hide the constructed-ness of its virtual reality

Narratives of Development: Models, Spectacles, and Calculability in Nick Cullather\u27s The Hungry World

To describe The Hungry World: America\u27s Cold War Battle Against Poverty in Asia as a history of the green revolution does not begin to convey the ambition and rewards of Nick Cullather\u27s new book. In less than three hundred pages, Hungry World offers a detailed diplomatic, intellectual, and cultural history that spans more than a century and three continents. Cullather deepens and revises our understanding of the green revolution as a history of the Rockefeller Foundation and its transfer of agricultural technology from Mexico to Asia, in part by showing how the green revolution\u27s intellectual and political construction involved a wider cast of characters and a much less linear and far more contested story of competing expertise and domestic and transnational political struggles. Hungry World brings together population science, the emergence of a geopolitics of hunger, struggles over the meaning of the New Deal, postwar images of the peasant village, competing models of development, and the green revolution\u27s political and social legacies. The enduring vision of the green revolution as a triumph of American science and technology requires, Cullather argues, the systematic forgetting of this complex history in favor of a simple narrative, a heroic parable of population, food, and science that ultimately fetters our ability to grapple honestly and effectively with poverty and hunger around the world (7-8)